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April 24, 2013

SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv

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April 24, 2013 (PDF version)
Featured Articles
Pain and Pain Management in NFL Spawn a Culture of Prescription Drug Use and Abuse
The Washington Post
April 13, 2013

This article and video (8:30 minutes) discuss prescription drug use among National Football League (NFL) players to mask or treat pain. The NFL's recently reported opioid use rate was three times higher than that of the general population. A 2000 survey of NFL physicians found 28 of 30 teams used injections of Toradol--a nonsteroidal anti-inflammatory prescription drug that treats postoperative pain--on game days. A study conducted 2 years later found an average of 15 pregame injections per team. Toradol's potential side effects include kidney damage and gastrointestinal bleeding. The drug can also diminish sensation--inhibiting an athlete's ability to feel pain or sense injury.

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NHL Wakes Up to Sleep Problems
Huffington Post
April 13, 2013

Prescription drug abuse is a problem in the National Hockey League (NHL). The NHL and the NHL Players' Association are working together to study Ambien use among players in the league. They will report their findings and make recommendations for the use of the prescription sleep medication this spring.

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Aussie Swimmers Fined for Drug Use Before Olympics
Taipei Times
April 20, 2013

Six Australian swimmers accused of prescription drug abuse were fined and suspended by Swimming Australia. Five of the swimmers admitted to taking the sleep medication Stilnox, banned by the Australian Olympic Committee, during a bonding session at a pre-Olympic camp. The sixth man denied taking the drug.

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Journal Articles

C.L. Hanson, S.H. Burton, C. Giraud-Carrier, J.H. West, M.D. Barnes, and B. Hansen. 2013. "Tweaking and Tweeting: Exploring Twitter for Nonmedical Use of a Psychostimulant Drug (Adderall) Among College Students." Journal of Medical Internet Research 15(4):e62. doi:10.2196/jmir.2503.

This study monitored Adderall discussions on Twitter, identifying variations in tweet volume during college exam periods, differences among groups of colleges and universities, and commonly mentioned side effects and co-ingested substances. Twitter status messages containing the word "Adderall" were collected from November 2011 to May 2012 and references to side effects and other commonly abused substances were noted. Tweets containing Global Positioning System data from individuals who were likely students were identified with clusters of nearby colleges and universities for regional comparison. From 132,099 unique user accounts, researchers found that 213,633 tweets mentioned Adderall. The number of Adderall tweets peaked during traditional final exam periods. Rates of Adderall tweeters were highest among college and university clusters in the Northeast and South regions of the United States; 27,473 (12.9 percent) referenced an alternative motive in the same tweet. Substances mentioned most often with Adderall were alcohol (4.8 percent) and stimulants (4.7 percent); the most common side effects were sleep deprivation (5.0 percent) and loss of appetite (2.6 percent). Adderall discussions on social networking sites such as Twitter may contribute to normative behavior regarding its abuse.

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A. Looby, K.P. De Young, and M. Earleywine. 2013. "Challenging Expectancies to Prevent Nonmedical Prescription Stimulant Use: A Randomized, Controlled Trial." Drug Alcohol Dependence. doi:10.1016/j.drugalcdep.2013.03.003.

This study examined the efficacy of a randomized controlled expectancy challenge intervention to prevent nonmedical prescription stimulant use among 96 at-risk, stimulant-naive college students (i.e., low grade-point average, Greek involvement, binge drinking, cannabis use). Forty-seven participants completed a brief expectancy challenge intervention aimed at modifying positive expectancies for prescription stimulants--to consequently deter initiation of use. The challenge successfully modified expectancies related to prescription stimulant effects, though the intervention and control groups showed comparable rates of nonmedical prescription use at the 6-month follow-up. However, negative expectancies may significantly predict reduced odds of future use, according to the authors.

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P. Madadi, D. Hildebrandt, A.E. Lauwers, and G. Koren. 2013. "Characteristics of Opioid-Users Whose Death Was Related to Opioid-Toxicity: A Population-Based Study in Ontario, Canada." PLOS ONE 8(4):e60600. doi:10.1371/journal.pone.0060600.
Researchers studied patterns and characteristics of opioid users whose deaths were related to opioid toxicity. All drug-related deaths in Ontario from 2006 to 2008 were reviewed at the Office of the Chief Coroner of Ontario to identify opioid involvement. Reviews included medical, toxicology, pathology, and police reports. Narratives and semi-quantitative and quantitative variables were extracted, tabulated, and analyzed. Of 2,330 drug-related deaths, 58 percent were partly or wholly attributed to opioids. Oxycodone was involved in one third of all opioid-related deaths. At least 7 percent of the cohort used opioids prescribed for friends or family; 19 percent inappropriately self-administered opioids (injection, inhalation, chewed patch); 3 percent were recently released from jail; and 5 percent had switched from one opioid to another near their time of death. Accidental deaths were significantly associated with personal history of substance abuse, enrollment in methadone maintenance programs, cirrhosis, hepatitis, and cocaine use. Suicides were significantly associated with mental illness, previous suicide attempts, chronic pain, and cancer history.

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S. Minozzi, L. Amato, and M. Davoli. 2013. "Development of Dependence Following Treatment with Opioid Analgesics for Pain Relief: A Systematic Review." Addiction 108(4):688-98. doi:10.1111/j.1360-0443.2012.04005.x.

Scientists searched Medline, Embase, CINHAL, and the Cochrane Library through January 2011. They included systematic reviews and primary studies reporting data on incidence or prevalence of opioid dependence syndrome among patients receiving strong opioids (or opioid-type analgesics) for acute or chronic pain treatment. Methodological quality was assessed using validated checklists. Data were extracted from 17 studies of 88,235 total participants. Studies included three systematic reviews, one randomized controlled trial, eight cross-sectional studies, and four uncontrolled case series. Most involved adult patients with chronic nonmalignant pain; two included patients with cancer pain. Only one study analyzed patients with a previous history of dependence. Incidence ranged from 0 to 24 percent (median 0.5 percent); prevalence ranged from 0 to 31 percent (median 4.5 percent). Available evidence suggests that opioid analgesics for chronic pain are not associated with major risk for developing dependence.
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H. Rhoades and S.L. Wenzel. 2013. "Correlates of Prescription Drug Misuse Among Heterosexually Active Homeless Men." Substance Abuse 34(2):143-49.
Researchers interviewed a representative probability sample of 305 heterosexually active homeless men from meal programs in the Skid Row region of Los Angeles, California. Interviews assessed demographics, substance use, mental health, and social networks. Logistic regression examined correlates of prescription drug misuse (PDM). Twenty-six percent of the study population reported PDM in the past year. PDM was more likely among homeless men suffering from posttraumatic stress disorder (PTSD) and among those with more substance-using social network members; decreased PDM was associated with good health. PDM prevalence is higher among homeless men in this study than among the general population. Correlates of PDM included PTSD and poor health--suggesting homeless men may use prescription drugs to self-medicate.
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News and Reports
U.S. Attorney's Office Advises on Rx Drug Problem in Southwest VA
April 17, 2013
According to a report from the U.S. Attorney's office, prescription drug abuse is rising in Southwest Virginia. Four counties make up 85 percent of all drug cases involving prescription drugs. To prevent doctor shopping, the report recommended requiring physicians to use the prescription monitoring program. Another recommendation encouraged employers to recognize and treat prescription drug abuse.
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Prescription Drug Abuse in Indiana
Journal Review
April 12, 2013
More than one million (20.7 percent) Hoosiers reported misusing psychotherapeutics at least once in their lives, according to a report from the Substance Abuse and Mental Health Services Administration. A total of 7.6 percent of residents ages 12 and older (383,000) engaged in nonmedical use of psychotherapeutics in the past year, and 2.7 percent (138,000) reported past-month use. Pain relievers had the highest rates of misuse and 18- to 25-year-olds had the highest rate of prescription pain medication abuse.

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Painkiller Fever in the Poconos
Pocono Record
April 14, 2013

Of Monroe County, Pennsylvania's 1,027 deaths investigated in 2011, 67 resulted from unintentional injuries and 27 were suicides. Fifty percent of unintentional injury deaths resulted from prescription drug use; 27 percent of suicides resulted from prescription drug use. Oxycodone demand was so high, many pharmacies ran out of the drug or refused to fill prescriptions. In a survey conducted by Use No Drugs, 13 percent of Mount Pocono residents said prescription drugs were their most common first-drug experience. Twenty percent said prescription medicine was the most commonly used drug among students.

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Cherokee Pharmacy Urges Safe Disposal of Unused Medicines
Cherokee One Feather
April 18, 2013

The Cherokee Indian Hospital Pharmacy encourages North Carolina residents to properly dispose of prescription drugs by participating in the Drug Enforcement Administration's National Prescription Take-Back Day, April 27 at the Cherokee Police Department. The pharmacy also shares Food and Drug Administration recommendations for proper disposal in this article.

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Rx Drug Abuse: Arkansas Uses Statistics to Guide Decisions
Hot Springs Village Voice
April 16, 2013

Arkansas health officials rely on statistics to determine how well they are reducing prescription drug abuse, using research from the Arkansas State Crime Laboratory, Arkansas Department of Health, Arkansas Crime Information Center, and Pride surveys. According to Arkansas Takeback, Arkansas has collected more than 23.5 tons of medication since September 2010. In fall 2012, 7.9 percent of students surveyed for the Arkansas Prevention Needs Assessment reported misusing prescription drugs over their lifetime, compared with 10.4 percent in fall 2010. Students who claimed they misused prescription drugs in the previous 30 days totaled 3.5 percent, compared with 4.4 percent in 2010.

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Gilson, Mount, Cleary, and Hutson: Prescription Drug Database Boon to State
The Cap Times
April 15, 2013

The authors describe Wisconsin's new Prescription Drug Monitoring Program and three limitations, including the fact that some prescribers do not know the program exists.

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Canada Won't Alter Oxy Policy Despite U.S. Decision to Bar Generics from Market
Sun News
April 17, 2013

In response to the U.S. Food and Drug Administration's decision not to approve generic versions of OxyContin, Canada said it will not shift its policy on generic forms of the drug. Minister Leona Aglukkaq's office maintained it lacks the legal authority to block drugs for market based on risk of abuse or misuse.

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Getting Unused Medications Out of Your Home Safely
KXO Radio
April 13, 2013

The Medsaway Medication Disposal System is a new product for properly disposing of prescription medication. Individuals place medications in a pouch, add water and seal the pouch, and throw the pouch away. A proprietary activated carbon system neutralizes the medication, chemically deactivating the drug. The pouch works with drugs in tablet, capsule, liquid, or patch form.

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Overdose of Baxter Springs Man Prompts New Drug Law in Kansas
The Republic
April 13, 2013

A new Kansas law added stiff penalties for defendants convicted of distributing drugs that cause death or great bodily harm. A drug dealer without a criminal record could receive a sentence of more than 12 years for selling a controlled substance that results in death. The bill surfaced after a man died of an overdose from a fentanyl patch he obtained illegally from a former co-worker.

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Heroin Is Back. Is Your Neighborhood Next?
USA Today
April 15, 2013

Because pain relievers are increasingly difficult to obtain, some people addicted to drugs are switching to heroin. Shortages are affecting those living in suburbs and small towns.

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Drug Overdose Prevention Could Be Right at Our Fingertips
Los Angeles Times
April 16, 2013

Naloxone can reverse a potentially fatal opiate overdose and is easy to administer, writes the author of this article. She emphasizes the need for greater availability of the drug.
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Prescription Drug Regulator Aimed at Curbing Painkiller Abuse
Medical Xpress
April 17, 2013

Students participating in Brigham Young University's Engineering Capstone program developed a device to curb prescription pain reliever abuse. The tamper- and break-resistant Med Vault container only dispenses pills according to doctors' orders. To access the Med Vault and load the pills, the device must be connected to a computer via USB. A pharmacist then uses software created by the students to specify how often pills can be retrieved daily. When the device is disconnected from a computer, it locks and dispenses only according to those instructions. As an added safety measure, patients must key in an access code listed on the bottle every time a pill is ready to be dispensed. The same container is used for refills.

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Inside the Coroner's Office: Utah Prescription Drug Deaths Remain High
Deseret News
April 12, 2013

In 2006, the Utah Department of Human Services took control to address unintentional overdose deaths. The Department increased awareness, provided education, and encouraged discussions about safe prescription drug use, storage, and disposal. Despite these efforts, the Utah Medical Examiner estimates seeing about 400 prescription drug-related deaths each year.

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Illegal Adderall Use Rises Among Students
The Miami Student
April 16, 2013

Adderall abuse is on the rise at Miami University. Several students admitted to taking the drug illegally to get good grades.

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Price Bill Seeks to Put Stop to Prescription Overdoses
Los Angeles Wave
April 18, 2013

California Senate Bill 62 would allow licensing boards to access data contained in coroners' reports on prescription drug overdose deaths. Boards could identify licensees in overprescribing circumstances and take action when needed.

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Prescription Overdoses on the Rise
Amarillo Globe-News
April 13, 2013

A physician in the Texas State Senate is drafting legislation for other doctors to efficiently monitor prescription drug use. Currently, doctors can look at the Prescription Drug Monitoring Database, but due to privacy restrictions, they cannot record the information on a medical chart. The senator also introduced tougher monitoring laws for Texas. Louisiana has adopted similar laws allowing police to monitor suspicious medical offices, which has caused several sham clinics to relocate to Texas.
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No Generic Version of Painkiller OxyContin, U.S. Health Regulators Say
April 16, 2013

The Food and Drug Administration (FDA) will not approve generic versions of the original form of OxyContin, which could be crushed and snorted or injected. FDA also approved new labeling for a reformulated version of OxyContin, indicating the tablets' physical and chemical properties make them more difficult to crush and abuse.

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Rx Drug Abuse: Stigma Often Prevents Abusers From Seeking Treatment
Times Record
April 17, 2013

Some healthcare workers and pharmacists are reluctant to get help for prescription drug addiction because of existing stigmas and potential consequences of exposure.

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FDA's Rejection of Generic OxyContin May Have Side Effects
National Public Radio
April 18, 2013

Experts say the Food and Drug Administration's decision to bar generic OxyContin may push patients toward less effective drugs, without eliminating the risk of addiction. Not having a generic version also means the medication will be more expensive.

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Funds to Run Out for Database That Monitors Prescription Drug Usage
April 15, 2013

Funding for California's prescription drug use database is on the chopping block. The state's Attorney General sponsored Senate Bill 809 to modernize and streamline the Controlled Substance Utilization Review and Evaluation System that monitors prescription drug use. If passed, the legislation would add staff investigators. The bill raises fees on prescribing professionals and taxes drug manufacturers who operate in the state.

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NSDUH Report: Nonmedical Use of Prescription-Type Drugs, by County Type
Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration
April 11, 2013

Over the past year, about 15.7 million people age 12 or older used prescription drugs nonmedically; 6.7 million did so in the past month. Past-year nonmedical use of prescription drugs was lower among people in rural counties than among those in metropolitan and urban nonmetropolitan counties (5.4 vs. 6.4 and 6.6 percent); past-month use was similar among the three county types. The rate of past-year nonmedical pain reliever use was lower in rural counties than in metropolitan and urban nonmetropolitan counties (4.2 vs. 4.9 and 5.1 percent), as was the rate of nonmedical tranquilizer use (1.8 vs. 2.1 and 2.3 percent). Stimulant and sedative nonmedical use rates did not vary by county type.

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New Research Reveals Link Between Marijuana and Inappropriate Use of Pain Medications, Other Prescription Drugs
April 12, 2013

Among chronic pain medication users, positive marijuana tests correlate with higher rates of potential prescription drug nonadherence. This study was conducted by Ameritox--a pain medication monitoring company--and presented at the American Academy of Pain Medicine's annual meeting. It included more than 100,000 urine samples from patients prescribed hydrocodone. Of the samples that tested positive for marijuana, 36.5 percent did not have the prescribed hydrocodone present. Of patients for whom no illicit drug was detected, 29.7 percent tested negative for hydrocodone use--a statistically significant finding. The research also found that 29.1 percent of samples positive for marijuana and 29.9 percent of samples positive for cocaine contained an additional non-prescribed medication, such as a tranquilizer. Only 22 percent of samples indicated an unexpected or non-prescribed medication was being used among patients without evidence of illicit drug use.

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The Council on Alcohol and Drugs and Georgia Law Enforcement Launch Statewide 'Operation Drug Drop Off' Campaign
The Wall Street Journal
April 17, 2013

The Council on Alcohol and Drugs (The Council) donated drug drop boxes to 128 counties in Georgia, where there are more law enforcement-maintained drop boxes than in any other state. The Council also launched a statewide drug drop box media campaign, "Operation Drug Drop Off," to publicize the boxes' presence. Program goals are to prevent prescription and over-the-counter drugs from getting into children's hands, keep such drugs off the street, and thwart overdoses and accidental poisonings.

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Neura Therapeutik Addresses FDA Concerns About Abuse, Misuse of Drugs With Development of Safe and Affordable Abuse-Deterrent Opioids
The Wall Street Journal
April 18, 2013

This press release discusses Neura Therapeutik's decision to accelerate development of abuse-deterrent brand and generic extended-release opioids. The company hopes to prevent common methods of abuse.

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Other Resources
President's FY 2014 Budget Request Includes Cuts to Key Prevention Programs
Community Anti-Drug Coalitions of America
April 18, 2013

View a funding chart that compares the President's FY 2014 Budget Request with FY 2012 enacted levels. The chart includes cuts to substance abuse prevention, treatment, and recovery fields.

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Radio Smart Talk: Prescription Drug Abuse Growing
April 17, 2013

Craig LeCadre, Senior Supervisory Special Agent at the Pennsylvania Office of Attorney General, provides information on prescription drug misuse. (52:07 minutes)

Senator DeSaulnier, A.G. Harris - SB809 Prescription Drug Abuse PC 4-15-13
California Senate Majority Caucus
April 15, 2013

Along with Senator Mark DeSaulnier and California Attorney General Kamala D. Harris, prescription drug abuse awareness advocates and law enforcement officials held a press conference to discuss legislation that would provide funding to save and modernize the Controlled Substance Utilization Review and Evaluation System. (25:21 minutes)

Grant Announcements
Harold Rogers Prescription Drug Monitoring Program FY 2013 Competitive Grant Announcement
Deadline: May 2, 2013
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Strategic Prevention Framework Partnerships for Success II SEOW Supplements
Deadline: May 31, 2013

The Substance Abuse and Mental Health Services Administration announced available funds to expand and enhance State Epidemiological Outcomes Workgroup (SEOW) activities funded under the Strategic Prevention Framework Partnerships for Success II (SPF-PFS II). The grant program was designed to address two national substance abuse prevention priorities: underage drinking among people ages 12 to 20 and prescription drug misuse and abuse among people ages 12 to 25. The supplemental grants allow SPF-PFS II grantees to expand and enhance current SEOW activities.

Read more:
Webinar Archive
Children's Safety Network Webinar Series on Prescription Drug Abuse Prevention Among Teens and Young Adults: Prescription Drug Abuse and Co-Occurring Psychiatric Disorders in Young Adults
April 9, 2013 (Duration: 1 hour)

Read more:
Presentation Replay:
PowerPoint Slides:
General Announcement
GIANT Food Stores and MARTIN'S Food Markets will collect unwanted prescription drugs during the Drug Enforcement Administration's Nationwide Prescription Drug Take-Back Day, April 27, from 10 a.m. to 2 p.m.
For drop-off locations, visit:
Upcoming Conferences and Workshops
2013 Symposium for Medical Professionals: Kentucky Medical Communities UNITEd
April 27, May 11, June 8, 2013
Various Cities; Kentucky
Drug Enforcement Administration's Sixth National Prescription Drug Take-Back Day
April 27, 2013
Various Locations Nationwide
Pharmacy Diversion Awareness Conference
May 4 and 5, 2013, in Detroit, Michigan
June 22 and 23, 2013, in Chicago, Illinois
July 13 and 14, 2013, in Portland, Oregon
August 3 and 4, 2013, in Baton Rouge, Louisiana
August 16 and 17, 2013, in San Diego, California
August 18 and 19, 2013, in San Jose, California
September 21 and 22, 2013, in Boston, Massachusetts
National Prevention Week 2013
May 12-18, 2013
Various Locations Nationwide
Prescription Drug Training
May 23, 2013
Reading, Pennsylvania
The Generation Rx University Conference for Prescription Drug Abuse Prevention and Recovery
August 7-8, 2013
Columbus, Ohio
2013 National Safety Council Congress and Expo
Congress: September 28-October 4, 2013
Expo: September 30-October 2, 2013
Chicago, Illinois
  Please e-mail Rekaya Gibson at rgibson@pire.org with questions or comments about the SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv.  
About PAW and the Listserv
The PAW TA Center addresses prescription drug abuse--a growing public health problem with increasing burdens on workers, workplaces, and our economy. Prescription drug abuse affects workplace productivity and increases employee absenteeism, employee presenteeism, and workers' compensation claims. On a wider scale, overdose deaths linked to prescription opioids tripled from 1999 to 2006, and prescription drug abuse killed more Americans in 2009 than died that year in auto crashes.
Send your request for PAW technical assistance to PAW-TA@pire.org or contact Rekaya Gibson at 504.261.8107 or Deborah Galvin at 240.276.2721. Requests are subject to SAMHSA approval. You will be notified of the status of your request.
We aim to conduct systematic and inclusive searches of professional journals, leading newspapers and magazines, and federal websites, as well as contributions from listserv subscribers (please e-mail suggestions to rgibson@pire.org). We will send links to articles along with brief descriptions of those articles. As we develop the listserv, however, we hope to add commentary and invite feedback from subscribers. Our goal is to expand the listserv to become a widely used and recognized source of the most current and authoritative information on prescription drug abuse--especially in workplaces.
The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" is a service provided by the SAMHSA Preventing Prescription Abuse in the Workplace Technical Assistance Center (PAW) to keep the field abreast of recent news and journal articles to assist in forming policy, research, and programs to reduce prescription drug misuse or abuse. Please note, the materials listed are not reflective of SAMHSA's or PAW's viewpoints or opinions and are not assessed for validity, reliability, or quality. The "SAMHSA Prevention of Prescription Drug Abuse in the Workplace Listserv" should not be considered an endorsement of the findings. Readers are cautioned not to act on the results of single studies, but rather to seek bodies of evidence. Copyright considerations prevent PAW from providing full-text journal articles.
The Injury Control Research Center at West Virginia University (WVU-ICRC) archives past Listserv issues at http://www.hsc.wvu.edu/icrc/Pages/SAMHSA-Prevention-of-Prescription-Drug-Abuse-in-th. The partnership efforts of WVU-ICRC are supported by Grant Number 1 R49 CE002109 from the Centers for Disease Control and Prevention (CDC). The contents of the Listserv archive are solely the responsibility of the authors and do not represent the official views of CDC or SAMHSA.

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